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  4. Comparative Analysis of Characteristics of Lower- and Mid-Cervical Spine Injuries in the Elderly

Comparative Analysis of Characteristics of Lower- and Mid-Cervical Spine Injuries in the Elderly

Spine Surg Relat Res, 2024 · DOI: 10.22603/ssrr.2024-0030 · Published: April 3, 2024

Spinal Cord InjuryAgingOrthopedics

Simple Explanation

This study compares lower- and mid-cervical spine injuries in elderly patients to understand differences in how these injuries occur and their effects. The research found that lower-cervical injuries in the elderly are more likely to result from high-energy trauma compared to mid-cervical injuries. Despite the injury location, a significant portion of patients with lower-cervical injuries still experience neurological deficits typically associated with mid-cervical injuries.

Study Duration
2010 to 2020
Participants
451 patients aged 65 years or older with mid- or lower-cervical fractures/dislocations
Evidence Level
Not specified

Key Findings

  • 1
    Elderly patients with lower-cervical injuries are significantly more likely to have sustained the injury from high-energy trauma compared to those with mid-cervical injuries.
  • 2
    A substantial proportion (25%-39%) of patients with lower-cervical injuries also exhibited neurological deficits at the mid-cervical level.
  • 3
    Patients with lower-cervical injuries were significantly less likely to undergo decompression surgery compared to those with mid-cervical injuries.

Research Summary

This retrospective study analyzed data from 451 elderly patients with mid- or lower-cervical spine injuries to compare their characteristics and outcomes. The study revealed that high-energy trauma and dislocation were significantly more common in elderly patients with lower-cervical injuries. Despite differences in injury mechanisms and levels, the study found no significant differences in death rates, pneumonia incidence, tracheostomy requirements, or ambulation ability after 6 months of treatment between the two groups.

Practical Implications

Enhanced Diagnostic Imaging

Comprehensive imaging of the cervicothoracic junction is crucial for elderly patients, especially those with high-energy trauma, to avoid missing lower-cervical injuries.

Tailored Treatment Strategies

Treatment approaches should consider the higher likelihood of high-energy trauma in lower-cervical injuries among the elderly.

Rehabilitation Focus

Rehabilitation programs for elderly patients with lower-cervical injuries should address potential mid-cervical level neurological deficits.

Study Limitations

  • 1
    Retrospective study design leading to potential selection bias.
  • 2
    Varied timing of MRI studies among patients.
  • 3
    Relatively small cohort size with dropouts during follow-up.

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